Provider Demographics
NPI:1699246520
Name:MARTENIA, YVONNE RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:RENEE
Last Name:MARTENIA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:YVONNE
Other - Middle Name:RENEE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1819 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5701
Mailing Address - Country:US
Mailing Address - Phone:541-479-2411
Mailing Address - Fax:541-479-2236
Practice Address - Street 1:1819 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5701
Practice Address - Country:US
Practice Address - Phone:541-479-2411
Practice Address - Fax:541-479-2236
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201809549NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily